MEDICARE: AUTISM OPPORTUNITIES FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1184084592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUTISM OPPORTUNITIES FOUNDATION

Provider Business Mailing Address
First Line	:	5860 BAKER RD
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-5903
Country	:	US
Telephone Number	:	952-767-4200
Fax Number	:	952-767-4211

Provider Business Practice Location Address
First Line	:	5860 BAKER RD
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-5903
Country	:	US
Telephone Number	:	952-767-4200
Fax Number	:	952-767-4211

Authorized Official
Title or Position	:	REVENUE CYCLE MANAGER
Name	:	RENITA WARE
Credential	:
Telephone Number	:	952-767-4200

Provider Enumeration Date	:	02/26/2016
Last Update Date	:	03/26/2025

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